Mogadishu’s refugees ‘waiting for death’ as Covid-19 reaches Somalia

In the Nabadoon camp on the outskirts of Mogadishu, Asho Abdullahi
Hassan, a 40-year-old mother of seven, has heard about the coronavirus
on the radio.

“I am very scared about this deadly virus. I only heard about it from
the news. It is like we are waiting for death to come,” she says.

The camp hosts about 3,000 families, most recently displaced from
Somalia’s Lower Shabelle region following an intensification of fighting
and US airstrikes.

Humanitarian activists are warning that it may be impossible to stop
the spread of the virus in such places, where sanitary precautions are
difficult and social distancing impossible. In Nabadoon, few can afford
soap and water is rare.

“This can get very bad. It will be hard,” said Patrick Youssef, deputy director for Africa at the International Committee of the Red Cross. “Our fear is that governments will seek to protect those they see as their own populations and people … in refugee camps will be left to fend for themselves.”

The spread of coronavirus in
Africa has been much slower than in Europe and Asia, but the World
Health Organization is concerned about a steep rise in cases across the
continent in recent days.

Tedros Adhanom Ghebreyesus, director general of the WHO, has warned
that official numbers may underestimate the scale of infection on the
continent. “Probably we have undetected cases or unreported cases,” he
said. “In other countries we have seen how the virus actually
accelerates after a certain tipping point, so the best advice for Africa
is to prepare for the worst and prepare today.”

South Africa, Senegal and Rwanda are the most recent countries to
impose stringent new restrictions on movement. President Cyril Ramaphosa
said police and army would enforce a three week lockdown from Friday.

But little attention has yet been paid to the 6.5 million refugees in sub-Saharan Africa, many living in precarious conditions, often already weakened by malnutrition and disease.

Health officials across Africa know that hospitals can deal with only a fraction of those needing care if the virus spreads through overcrowded cities, remote villages and among vulnerable populations such as those suffering from HIV and other chronic conditions.

Nigeria, Africa’s most populous nation, on Monday reported its first death from Covid-19, as the country’s overall number of confirmed cases rose to 36.

Prisoners and other detainees, such as those in detention centres for migrants, are also a concern, said Youssef.

Uganda,
which has nine confirmed cases, hosts more than 1.4 million refugees,
with more arriving every day from from South Sudan, the Democratic
Republic of the Congo and, to a lesser extent, Rwanda and Burundi.

Professor Pauline Byakika, a specialist in infectious diseases at
Uganda’s Makere University, said prevention and control were key to
fighting the virus in the crowded conditions of most refugee camps.

“This is a highly infectious disease,” Byakika said. “They are
crowded, they don’t have handwash facilities – they don’t even have hand
sanitisers – [and] distance between one patient and the other is so
close.”

Jane Ruth Aceng, Uganda’s minister of health, said that any case of Covid-19 in refugee camps would be treated like outbreaks elsewhere.

“We have tents that we have procured, and [which are] ready to be set
up to manage people who may get infected wherever,” she said. “For
those who are severely ill, they will be referred and managed in the
regional referral hospitals whose capacities are being built to handle
Covid-19.”

The UNHCR, the UN refugee agency, has launched a campaign to educate
refugees in Uganda about hygiene and sanitation, increase distributions
of soap and hand sanitiser, and train health workers.

Experts believe some camps might be shielded to a degree by their
distance from urban areas that are the usual entry points of the virus
to countries. The age profile of many refugee settlements – with a very
high proportion of young people and children – may also boost their
resilience.

But a significant risk is that the focus on the threat of coronavirus will distract from other needs.

Ma’ow Ali Mohamud, a 56-year-old father of eight in a displacement camp in the Hodan area of Mogadishu, said his priority was food. “We only eat one meal every day. I am not bothered about coronavirus. We are lacking food. We do not have clean drinking water. That is my first priority,” he said.

A neighbour, Maryan Abdi Yarow, 70, said she and her family were
without protection against the disease. “My children are malnourished.
We do not have access to basic healthcare and now they are saying
coronavirus has been confirmed in Somalia. If someone is infected then what can they do? Nothing at all.

“The government cannot even provide us clean water for drinking in
this displacement camp. There are only six toilets for 1,000 families
here. We are praying to God to help us.”

Many refugees and displaced people live in villages or cities, not in
camps. These include some vulnerable communities. Across Africa, LGBT
men and women face discrimination and may be reluctant to seek medical
help or inform the authorities about infection. In most African
countries gay sex is illegal and potentially punished by long prison sentences, or even death.

“We are in the midst of a public health emergency causing panic,
death and fear on an international and widespread level,” the Refugee
Coalition of East Africa, which represents a number of LGBT refugee
organisations in the region, said in a statement.

“It merits the attention of the world and its leaders. [But] at the same time, we implore humankind to not let us slip from your consciousness.”

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